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NPI Code Detail

MEDICARE: KATHERINE MATTHEWS

MEDICARE: KATHERINE MATTHEWS
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1103K00000XBehavior Analyst1106758VA

General Provider Information

NPI Number : 1811247836
Entity Type Code : Individual
Provider Name (Legal Business Name) : KATHERINE MATTHEWS
Provider Business Mailing Address
First Line : 1701 BYRD AVE
Second Line :
City : RICHMOND
State : VA
Zip : 23230-3011
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 1701 BYRD AVE
Second Line :
City : RICHMOND
State : VA
Zip : 23230-3011
Country : US
Telephone Number : 804-612-1953
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/18/2012
Last Update Date : 09/18/2012

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Directions to “ KATHERINE MATTHEWS ” Practice Location

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